Premenstrual Syndrome (PMS)  has been around as long as we’ve been having periods. But what used to be a taboo topic and often the butt of sexist jokes, is now an active point of conversation among women. With the period-related chat flowing, the door is finally open for researchers to give women the answers we’ve been waiting for, and it’s interesting to see the impact your cycle could be having on your mental health.

PMS Symptoms

For 90% of women who menstruate, PMS symptoms are a regular visitor in the week leading up to their period – lucky us.  Some common (but rather unpopular) alarm bells Mother Nature uses to signal the return of your menses can include:

PMS and Mental Health

PMS symptoms are extremely common and could be explained by the fluctuations in your hormone levels triggering changes in your serotonin levels. Serotonin (also known as the “happy chemical”) is believed to help keep in check your mood, social behaviour, appetite and digestion, sleep, memory and function. If you already suffer from anxiety disorders or other mental health conditions, you may also experience a magnification in your existing symptoms the week before your period.

The difference between PMS and PMDD

So most of us suffer from PMS symptoms in some way, but unfortunately, as many as 20-40% of women have several even more severe PMS-related problems that are detrimental to their overall wellbeing and mental health.

In 5 to 8% of these women, these symptoms – in particular the psychological ones – are so debilitating that they get in the way of living a normal daily life and can make it difficult to work, socialise and maintain healthy relationships. The medical term for this is premenstrual dysphoric disorder (PMDD).

Much like PMS, PMDD comes creeping up on its beholders around a week before their cycle starts, and will usually disappear once you begin menstruating.  But how do you distinguish the difference between PMDD and regular old PMS?

Let’s think of PMDD as PMS’ evil twin, she’s even meaner, bigger, and she’s definitely not your mental health’s friend. Symptoms can often include:

  • Depressed mood or feelings of hopelessness
  • Anxiety or tension
  • Unstable, rapidly changing emotions
  • Irritability
  • Decreased interest in social activities
  • Concentration struggles
  • Lethargy and low energy levels
  • Change in appetite, cravings 
  • Change in sleep patterns
  • Feeling overwhelmed or out of control
  • Various physical symptoms, such as pains, abdominal bloating, diarrhoea or constipation

In the most severe cases of PMDD, women can also experience suicidal thoughts.

What are the causes of PMS and PMDD?

Sadly, the exact causes behind PMS and PMDD are unknown. However, recent research into PMDD suggests that it is linked to an increased sensitivity to the hormonal changes that occur during your monthly menstrual cycle. 

Following ovulation, your progesterone and oestrogen levels rise in preparation for potential pregnancy, but if conception doesn’t occur they soon drop and trigger your period. The more sensitive you are to these hormonal changes is a possible explanation for your changes in mood, which could be genetic.

Stress factors must also be considered when assessing the causes of PMS and PMDD, as (along with all their other negative side effects) these factors can heighten symptoms. It could also be triggered by certain lifestyle habits such as excessive drinking, drug use and obesity.

Dealing with PMS and PMDD

So what now you’re asking – are you expected to put up with these symptoms every month and just get on with it? Whilst there are few non-medical treatments for PMS and PMDD – we’ve got some tips to help take control of yours and its effects on your mental health.

If you don’t already, try tracking your symptoms to see if there’s a correlation between your most anxious or irritable moments and the stage of your cycle. Once you have control over this, your symptoms can become more manageable – even if that means clearing your social diary for a few days whilst you practise some well-deserved self-care. 

You’ve heard it all before, but we’re telling you again, eating well and exercising regularly is proven to have a positive impact on your symptoms and of course, your overall health will be thanking you too.

Some prescription hormonal contraceptives have also been shown to improve PMDD sufferers mental health. As it halts the ovulation process and reduces the natural fluctuation of your hormones – it might help lessen your symptoms, but always seek advice from a medical professional before taking this action.

For the more severe cases of PMDD – cognitive behavioural therapy (CBT) is also considered an effective treatment.

If your experience of severe PMS or PMDD symptoms is regularly affecting your wellbeing, it can be extremely beneficial to talk to a professional. The idea of diagnosing a mental health disorder can be daunting, but it is the first and most important move in alleviating your suffering. 

Resources: 

https://www.mind.org.uk/
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